Abstract 9637: Associations of Routine Repeat Stress Echocardiography With Outcomes in Stable Patients With Prior Abnormal Testing
Background: The optimal follow-up (f-up) strategy of stable medically managed pts with previous abnormal stress imaging test results is unknown. While repeat testing is considered inappropriate early (<2 y) after the initial test, the appropriateness of later testing is indeterminate. We sought to compare the effects of a repeat testing f-up strategy to that of no repeat testing.
Methods: We identified 606 stable pts [mean (SD) age 62.7(10.7); 52% male] with abnormal stress echocardiography (SE) results. Among these, 105 had a repeat SE >2 y after the initial test (cases) while 501 did not have repeated testing (controls). Pts were followed for 6.7 y for the occurrence of revascularization (RVS), overall and cardiac death (CD), myocardial infarction (MI) and a composite outcome of CD+MI. Association of the f-up strategy with outcomes was assessed using Cox models.
Results: The baseline characteristics of both groups were similar. The rate of outcomes was similar in both groups except more frequent referral for RVS in cases (7.6% vs. 3.4%, p=0.04). Cox regression analyses failed to identify any significant association between the f-up strategy and any of the specified outcomes (Fig.1). The site, extent (single vs. multi-vessel) and type of the SE abnormality (ischemia or scar) were also not predictive of outcome.
Conclusion: Routine, repeat testing during f-up is associated with higher referral rate for RVS in medically-managed pts with abnormal prior stress imaging, but no identifiable survival benefit.
- © 2013 by American Heart Association, Inc.